Intraoperative Adverse Events and Related Postoperative Complications in Spine Surgery: Implications for Enhancing Patient Safety Founded on Evidence-Based Protocols
SpinePublished 1 June 2006
Y. Raja Rampersaud, Eduardo Moro, Mary Ann Neary, Kevin P. White, Stephen J. Lewis, Eric M. Massicotte
Citations203
SJR quartileQ1
SJR score1.22
SNIP1.48
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TL;DR
Adverse events can frequently occur during spinal surgery, however, the majority are not associated with complications, and preventative approaches to enhance patient safety can be developed.
Abstract
Adverse events can frequently occur (14%) during spinal surgery, however, the majority (76.5%) are not associated with complications. Improved patient safety can only be maximized by independent practice audit and the development of prospective methods to record adverse event data so that enhanced, evidence-based, clinical protocols can be developed.
Keywords
Medicine
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Journal of Bone and Joint SurgeryDural Tears Secondary to Operations on the Lumbar Spine. Management and Results After a Two-Year-Minimum Follow-up of Eighty-eight Patients*
406 Citations1998Jeffrey C. Wang, Henry H. Bohlman +1 more
A dural tear that occurs during an operation on the lumbar spine can be treated successfully with primary repair followed by bed rest and does not appear to have any long-term deleterious effects or to increase the risk of postoperative infection, neural damage, or arachnoiditis.
SpineIncidental Durotomy in Spine Surgery
401 Citations2000Frank P. Cammisa, Federico P. Girardi +4 more
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SpineIn Vivo Accuracy of Thoracic Pedicle Screws
390 Citations2001Philip J. Belmont, William R. Klemme +2 more
The accuracy of thoracic screw placement within the pedicle and vertebral body and the resultant transverse screw angle (TSA) were assessed by postoperative CT and the incidence of fully contained screws was directly correlated with the region of instrumentedThoracic spine.
PubMedFactors influencing quality of life in cancer patients: anemia and fatigue.
384 Citations1998David Cella
The FACT-An subscale was initially validated in a cohort of 50 cancer patients, and tests of internal consistency and stability confirmed the reliability of the fatigue component, as well as that of the Fact-G (27 items), the F ACT-F (FACT-G plus 13 fatigue items), and the Ffact-An (Facts plus 20 anemia subscale items) measurement systems.
Journal of Neurosurgery SpineVisceral and vascular complications resulting from anterior lumbar interbody fusion
376 Citations1999Viswanathan Rajaraman, Roy Vingan +4 more
Although many of these complications have been recognized in the literature, the significance of sympathetic dysfunction appears to have been underestimated and the high incidence of complications in this series likely reflects the strict criteria.
SpineThe Incidence of Complications in Endoscopic Anterior Thoracolumbar Spinal Reconstructive Surgery
375 Citations1995Paul C. McAfee, John R. Regan +6 more
The endoscopic spinal approaches proved to be safe operative procedures in 100 consecutive cases and there were no permanent latrogenic neurologic injuries and no deep spinal infections.
Journal of Bone and Joint SurgeryPlacement of pedicle screws in the thoracic spine. Part I
349 Citations1995Alexander R. Vaccaro, Steven J. Rizzolo +5 more
The morphometric data revealed wide variations in the dimensions of the pedicles, demonstrating the importance of accurate preoperative imaging with transaxial computerized tomographic scans to visualize the precise osseous margins and angles of insertion of the thoracic pedicles.
SpineVascular Injury in Anterior Lumbar Surgery
331 Citations1993James K. Baker, Patrick R. Reardon +2 more
Although the authors are unaware of any major long-term morbidity from this complication in their patient group, they believe the true incidence of this potentially quite serious complication may be underestimated.
NeurosurgeryPosterior C1-C2 Transarticular Screw Fixation for Atlantoaxial Arthrodesis
316 Citations1998Curtis A. Dickman, Volker K.H. Sonntag
The risk of screw malpositioning and catastrophic vascular or neural injury is small and can be minimized by assessing the position of the foramen transversaria on preoperative computed tomographic scans and by using intraoperative fluoroscopy and frameless stereotaxy to guide the screw trajectory.
SpinePosterior Occipitocervical Reconstruction Using Cervical Pedicle Screws and Plate–Rod Systems
310 Citations1999Kuniyoshi Abumi, Takashige Takada +3 more
Results of this study showed the effectiveness of cervical pedicle screw as a fixation anchor for occipitocervical reconstruction, which provided the high fusion rate and sufficient correction of malalignment in the occipitoatlantoaxial region.
SpineComplications of Posterior Cervical Plating
309 Citations1995John G. Heller, D. Hal Silcox +1 more
Cadaveric work has predicted certain anatomic complications rates associated with lateral mass screw insertion, but this study finds the risk of lateralmass screw insertion to be considerably less than predicted in vitro.
Journal of Bone and Joint SurgeryTreatment of dural tears associated with spinal surgery.
308 Citations1981Frank J. Eismont, Samuel Wiesel +1 more
Five consecutive patients with tears of the spinal dura with postoperative leaks of cerebrospinal fluid require reoperation and meticulous closure of the dura, with problems in cluded the persistence of cerebrspinal-fluid fistulas.
SpineAirway Complications Associated With Surgery on the Anterior Cervical Spine
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Patients with prolonged procedures exposing more than three vertebral levels that include C2, C3, or C4 with more than 300-mL blood loss should be watched carefully for respiratory insufficiency and a history of myelopathy, spinal cord injury, pulmonary problems, smoking, and anesthetic risk factors did not correlate with an airway complication.
European Spine JournalComplications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations
291 Citations2002Paul C. Jutte, René M. Castelein
The study confirmed that pedicle screw placement is a technically demanding procedure with a high complication rate, but most complications are not severe and can be minimised by careful tactile technique.
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270 Citations2002Salvador A. Brau
Journal of Neurosurgery SpineDirect anterior screw fixation for recent and remote odontoid fractures
268 Citations2000Ronald I. Apfelbaum, Russell R. Lonser +2 more
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Journal of neurosurgeryTranspedicular screw-rod fixation of the lumbar spine: operative technique and outcome in 104 cases
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232 Citations2004Serena S. Hu
There are several factors that can put patients at increased risk for greater intraoperative blood loss and these factors will be discussed.
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224 Citations2000Susanna Andersson, Claes Olerud +1 more
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Journal of Bone and Joint SurgeryUpper-airway obstruction after multilevel cervical corpectomy for myelopathy.
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SpineEsophageal Perforation Following Anterior Cervical Spine Surgery
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159 Citations1994John G. Golfinos, Curtis A. Dickman +3 more
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European Spine JournalEarly complications of spinal pedicle screw
153 Citations1997Adnan A. Faraj, J K Webb
The conclusion was that pedicle screw fixation has an acceptable complication rate and neurological injury during this procedure is unlikely.
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CHEST JournalImpact of Respiratory Complications on Length of Stay and Hospital Costs in Acute Cervical Spine Injury
151 Citations2002Christopher Winslow, Rita Bode +3 more
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145 Citations1999Brian R. Subach, Michael A. Morone +4 more
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137 Citations2002Philip J. Belmont, William R. Klemme +2 more
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The Spine JournalLateral mass screw–rod fixation of the cervical spine: a prospective clinical series with 1-year follow-up
129 Citations2003H. Gordon Deen, Barry D. Birch +2 more
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126 Citations2000Umberto Agrillo, Luciano Mastronardi +1 more
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Acta Orthopaedica ScandinavicaPosterior lumbar interbody fusion: A retrospective study of complications after facet joint excision and pedicle screw fixation in 148 cases
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Lateral mass plate fixation is safe and effective with the authors' surgical technique, and Posterior cervical plate stabilization is a viable alternative to more traditional wiring techniques.
Journal of Bone and Joint Surgery - British VolumeA new method of stabilising the elevated laminae in open-door laminoplasty using an anchor system
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NeuroradiologyVascular complications in lumbar disk surgery: report of four cases
109 Citations1996Dieter Szolar, K. Preidler +6 more
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107 Citations2001Thomas E. Geyer, Michael A. Foy
Oral extrusion of cervical spine grafts or instrumentation is rare but potentially serious, and each case of instrumentation failure should be assessed individually to decide if conservative management is appropriate or if reoperation should be considered.
SpinePosterior Cervicothoracic Instrumentation in Spine Tumors
103 Citations2004Christian Mazel, É. Hoffmann +4 more
Posterior plate or rod and screw fixation is a good method of treatment for cervicothoracic instability in spine tumors and reflects attempts to improve accuracy in light of variable facet and pedicle interspaces.
Clinical Orthopaedics and Related ResearchComplications and Problems Related to Pedicle Screw Fixation of the Spine
103 Citations2003Pavlos Katonis, Joseph J. Christoforakis +4 more
The rate of the reported complications was high and the final outcome of the patients was not affected significantly, and placement of the pedicle screws in the thoracolumbar and lumbar spine is a technically demanding procedure.
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99 Citations2004Hakan Bingöl, Faruk Cíngöz +3 more
Despite its low incidence, iatrogenic vascular injury related to lumbar disc surgery is a possible complication and early diagnosis of vascular injuries and urgent transperitoneal surgery can save patients' lives.
Surgical NeurologyVertebral artery complications in anterior approaches to the cervical spine
89 Citations2003Dorothea Daentzer, Wolfgang Deinsberger +1 more
In ventral approaches to the cervical spine, precise preoperative planning and a detailed knowledge of the surgical anatomy are mandatory to prevent complications arising from fistulas, late-onset hemorrhages, pseudoaneurysms, thrombosis, and emboli.
Journal of Spinal DisordersAccuracy of Pedicle Screw Placement with the Assistance of Lateral Plain Radiography
89 Citations1996Charles J. Odgers, Alexander R. Vaccaro +2 more
Pedicle screw insertion in the thoracolumbar spine with the use of lateral plain radiography alone is safe and effective, and it minimizes operative time and expense.
European Spine JournalComparative study of laparoscopic L5?S1 fusion versus open mini-ALIF, with a minimum 2-year follow-up
87 Citations2003Sang Ki Chung, Sang‐Ho Lee +5 more
The laparoscopic ALIF for L5–S1 showed similar clinical and radiological outcome when compared with open mini-ALIF, but significant advantages were not identified, despite its technical difficulty.
European Spine JournalAn overview of blood-sparing techniques used in spine surgery during the perioperative period
85 Citations2004Marek Szpalski, Robert Gunzburg +1 more
Several blood-saving procedures and drugs, as well as promising new agents, appear to be efficient, although their efficacy has yet to be assessed by proper randomized controlled trials.
Annals of Otology Rhinology & LaryngologyDelayed Pharyngoesophageal Perforation: A Complication of Anterior Spine Surgery
82 Citations1991Mark F. Kelly, Joseph R. Spiegel +2 more
Four cases of delayed injury to the pharynx and esophagus that resulted in abscess or fistula are presented and it is postulate that graft displacement with resulting erosion was responsible for these serious complications.
Surgical NeurologyPosterior C1-C2 transarticular screw fixation in the treatment of displaced type II odontoid fractures in the geriatric population—review of seven cases
75 Citations1999Michael Campanelli, Keith A. Kattner +3 more
Posterior transarticular screw fixation is a reasonable option in treating displaced Type II odontoid fractures, and seven geriatric patients tolerated this surgery well, and were mobilized early, avoiding complications related to external immobilization.
Journal of Spinal DisordersEsophageal Perforation After Anterior Cervical Plate Fixation
73 Citations1992Michael D. Smith, Michael J. Bolesta
Close observation is needed for screw back out in patients with associated neurologic deficits or osteoporosis after anterior plate fixation of the cervical spine in cases of esophageal complications due to migration of screws.
Canadian Journal of Anesthesia/Journal canadien d anesthésieIntracranial subdural hematoma after unintended durotomy during spine surgery
68 Citations2002Chueng‐He Lu, Shung‐Tai Ho +3 more
This case reminds us that subdural hematoma formation can complicate durotomy during spine surgery and Neurological deterioration in the postoperative period should prompt clinicians to rule out the diagnosis and intervene rapidly as appropriate.
Acta NeurochirurgicaVascular complications of lumbar disc surgery
65 Citations1996J. Fruhwirth, G. Koch +3 more
The risk of injuring the pelvic vessels intra-operatively can be explained by the close anatomical relation between the retroperitoneal vessels and the vertebral column and furthermore not only by the fact that pre-existent deficiencies but also injury to the anterior longitudinal ligament give access to the retro peritoneal space.
Surgical NeurologyAnterior screw fixation of odontoid fractures
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Successful anterior screw fixation gives the best anatomical and functional results for odontoid fractures.
Surgical NeurologyVertebral artery pseudoaneurysm complicating posterior C1-2 transarticular screw fixation: case report
63 Citations2001Vikram C. Prabhu, John C. France +2 more
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Acta Orthopaedica ScandinavicaPosterolateral lumbosacral fusion with transpedicular fixation:63 consecutive cases followed for 4 (2–6) years
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Journal of Spinal DisordersSafety and Efficacy of Pedicle Screw Placement for Adult Spinal Deformity with a Pedicle-Probing Conventional Anatomic Technique
58 Citations2000Oheneba Boachie–Adjei, Federico P. Girardi +2 more
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SpineCerebellar Hemorrhage Complicating Cervical Durotomy and Revision C1-C2 Fusion
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Postoperative drainage of cerebrospinal fluid, especially when negative pressure is applied, may play a role in the occurrence of cerebellar hemorrhage.
The Spine JournalVascular anatomy anterior to lumbosacral transitional vertebrae and implications for anterior lumbar interbody fusion
46 Citations2001Bradley K. Weiner, Matthew Walker +1 more
If anterior lumbar surgery is to be performed at the functional lumbosacral junction in the presence of transitional vertebrae, it is vital that close attention be paid to the vascular anatomy and more open techniques of approach should be considered.
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Journal of Spinal DisordersAnderson Type II Fracture of the Odontoid Process: Results of Anterior Screw Fixation
44 Citations2000Hesham ElSaghir, Heinrich Böhm
A prospective study of 30 cases with Anderson type II fracture of the odontoid process treated by direct anterior fixation using the two-screw technique, finding that two 2.7-mm self-tapping titanium cortical screws provided adequate stability for fixation of type II odontoids fractures.
NeurosurgeryEsophageal Perforation during Surgery on the Cervical Spine
43 Citations1991D.P. van Berge Henegouwen, Jan-Anne Roukema +2 more
NeurosurgeryEsophageal perforation during surgery on the cervical spine
42 Citations1991D.P. van Berge Henegouwen, Jan A. Roukema +2 more
Differences in the time of diagnosis of this complication in three patients--no delay and delays of 6 hours and 4 days, respectively--resulted in different symptoms and outcomes.
Journal of Spinal DisordersAcinetobacter baumanii Meningitis
33 Citations2004Dorian J. deFreitas, John P. McCabe
This case highlights the importance of repairing all dural tears and commencing antibiotics that cover uncommon bacteria in those who develop symptoms of meningitis in this setting.
Journal of Spinal DisordersAnterior Dural Laceration Caused by Thoracolumbar and Lumbar Burst Fractures
25 Citations2000Allen Carl, Morio Matsumoto +1 more
In patients with anterior dural laceration, primary repair is warranted and can be performed more easily after intraoperative correction of kyphosis and subarachnoid drainage may be effective in cases of continued postoperative anterior cerebrospinal fluid leakage before repeated operation is considered.
SpineAmaurosis Secondary to Massive Blood Loss After Lumbar Spine Surgery
25 Citations1994SCOTT S. KATZMAN, Constantine G. Moschonas +1 more
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